Hoverboard Hazards

The exciting new phenomena of “hoverboarding” has made hoverboards one of the most popular technological “toys” on the market today.  Intended for agile adolescents, its appeal has also drawn parents and other adults nostalgic for those days gone by.

The technology of the hoverboard, known as a smartboard or balance board as well, doesn’t actually create a hover but rather a forward and backward motion on a sideways skateboard of sorts, with either a large single center wheel or two smaller ones at each end.  It is automated, can reach a formidable speed of 16 mph and relies on body movement for navigation. It is basically a hands free, self-balancing electric scooter.

Concern over hoverboard safety grows amid increase in injuries.

Concern over hoverboard safety grows amid increase in injuries.

They have become the vehicle of choice for students travelling around campus and preteens maneuvering around the house and down the street to visit friends.  They light up, are stealth quiet, move as fast as one’s imagination …. and leave hands free for any other activity desired on the fly.

Unfortunately, while the mainstream hoverboard never actually leaves the ground, its ability to send riders airborne is causing increasing concern.

In fact, the Consumer Product Safety Commission has reported receiving dozens of hoverboard-related injuries from across the United States.  Houston hospitals have also reported in a recent Associated Press article seeing a sharp increase in the number of hoverboard accidents sending adult and young riders alike to the ER and urgent care clinics.

Colleges are not only restricting their use on campus, as a result of the injury risk (to the user and passers by) but also the fire hazard their electrical system poses.  The hoverboard fire hazard is covered extensively in other hoverboard reports.

Among the most common musculoskeletal injuries seen from hoverboard use include concussions, fractures, contusions and abrasions.

Concussions

While most frequently seen in sports such as football and soccer, concussions are increasingly reported in hoverboard accidents.  With no recommended safety wear, the speed and maneuverability of the device is resulting in high impact falls and collisions – resulting in concussions. The primary symptoms of a concussion include:

  • Headache
  • Trouble concentrating, feeling “foggy”
  • Nausea
  • Delayed reaction times
  • Dizziness, lightheadedness
  • Sensitivity with bright lights or loud sounds
  • Irritability

 If a concussion is suspected, an evaluation should be conducted by a physician and hoverboard and other balancing activities should be avoided.

Fractures

Wrist fractures are among the most common types of fractures seen in hoverboard accidents – distal radius fractures among the most common type of wrist fracture.  This is often the result of breaking a fall or harsh impact with an outstretched arm. Other hoverboard fractures and dislocations have been seen in the fingers. Symptoms of a fracture or dislocation can be evident with extreme pain, swelling and slight disfigurement or subtle with only slight swelling and pain.

Most wrist fractures and finger fractures and dislocations can be treated nonsurgically, depending on the severity of the fracture or dislocation.  A splint or other bracing may be indicated, along with anti-inflammatory medication and rest/refrain from extracurricular activity.

Contusions and Abrasions

Collisions causing contusions and abrasions are frequently reported on hoverboards in the absence of safety gear. While most are minor cuts and scraps, some may result in open wounds requiring stiches, while potentially damaging nerves and other soft tissue.  Swollen, discolored injuries lasting more than a month should be further evaluated by a physician.

Preventing Hoverboard Injuries

The lack of safety standards and recommended safety gear/wear is a concern among hoverboard retailers and healthcare providers alike.  But, parents do not have to wait until such recommendations are established.  If a hoverboard is in your family’s future, take the proper precautions. As with any sport, safety gear recommended or not, will provide a bit of assurance.

Cyclists travelling at much less speeds not only have both hands and legs navigating a two-wheeled structure designed for the road, but also helmets, gloves, shoes and other gear designed for safety and the sport. This is also true of rollerbladers and skateboarders. Invest in the safety of your hoverboard rider and purchase protective safety gear.

Help young riders understand the potential risks for injury and encourage that they err on the side of caution to avoid the ER.

Have fun and be safe!

Read a hoverboard article from a young contributing writer.

 

Protecting Fingers in Fall Sports

Behind the catches, interceptions, tips, tackles and returns are some of the most commonly reported sports injuries in football, as well as other fall and winter sports – finger injuries.Football Finger Injuries

Finger injuries actually represent one of the most common body injuries in sports in general and include sprains, dislocations, tendon damage and fractures. They are very common in football, basketball and volleyball.

Rarely does a finger injury go unnoticed.  They can be very painful and more challenging to heal, as our hands are constantly in use in everyday activity.Basketball Finger Injuries

Some of the most common causes of a finger sports injury include:

  • Struggle to maintain (as well as strip) a football
  • Clashes with teammates and opponents
  • Awkward and sudden impact with a ball
  • Catching or pulling on a jersey
  • Falls onto a hard surface

Sprains and DislocationsVolley Ball Finger Injuries

Finger sprains generally represent damage to the collateral ligaments, which are band-like structures that stabilize the finger and prevent side to side movement. It most frequently occurs in the mid finger. The little finger, middle finger and thumb are the fingers most affected in such injuries.

A finger sprain can vary in severity and is graded on a scale of 1-3. Grade 1 represents the mildest type of sprain, a stretched ligament.  Grade 2 is a partially torn ligament, and Grade 3 represents one that is completely torn.  When a Grade 3 finger sprain is sustained and bones are also out of place, altering joint surface contact, it is diagnosed as a finger dislocation.

A finger dislocation may be identified as an MCP (metacarpophalangeal), DIP (distal interphalangeal) or PIP (proximal interphalangeal) dislocation depending on the finger joint and bone it affects.

Finger sprains are also often referred to as a “jammed finger.”

Depending on the severity of a “jammed finger,” symptoms may include:

Finger Anatomy

 

  • Pain and immediate swelling
  • Bruising and pain during activity
  • Impaired function
  • Deformity
  • Stiffness and difficulty during gripping activity

Tendon Injuries

Tendons in the hand are tissues connecting muscle to bone, which when contracted pull on bones causing fingers to move. These muscles moving the fingers and thumb are located in the forearm – long tendons extending through the wrist and attaching to the small bones of the fingers and thumb.

The tendons on the top of the hand straighten the fingers and are known as extensor tendons. Those on the palm side bend the fingers and are known as the flexor tendons.

When fingers are bent or straightened, the flexor tendons slide through snug tunnels, called tendon sheaths, keeping the tendons in place next to the bones.  A tendon rupture disrupts this natural flow.

A relatively common tendon injury of the hand diagnosed in fall sports is a tendon rupture, also called a “Jersey Finger.”  This occurs in a “tear-away” type of activity, such as grasping a jersey with finger(s) in a flexed position – and then forced straight as the player quickly moves in another direction.  The result is loss of flexion at the DIP joint because of damage to the flexor tendon.

An injury to the tip of the finger may result in extensor tendon damage, which is also known as a “Mallet Finger.”

Symptoms of a flexor or extensor tendon rupture may include:

Flexor

  • An inability to bend one or more joints of your finger
  • Pain when your finger is bent
  • Tenderness along your finger on the palm side of your hand
  • Swelling of the finger

Extensor

  • Inability to open or extend the hand or fingers
  • Pain
  • Swelling or weakness of the finger
  • Cut to the back of the hand or fingers

Finger Fractures

Among the more severe finger injuries occurring in sports are finger fractures.  This is a break in one of the small bones of the finger.  Finger fractures may be stable or unstable.  Among the most common finger fractures include; distal phalanx (also known as a Tuft Fracture and associated with “crush” injuries), mallet, flexor digitorum profundus avulsion, and middle and proximal phalanx fractures (non-displaced, unstable, or displaced – which are usually more complex fractures to treat).

The correct diagnoses and treatment of a finger fracture, which can often mimic a finger sprain or dislocation in pain and symptoms, is imperative in ensuring optimal long-term function.

DIAGNOSIS

While many finger injuries can be diagnosed with a physical examination, an x-ray is indicated to more thoroughly assess the injured area or possible fracture – and severity of the injury. A CT scan may also be used to evaluate complex fractures. An MRI is often used when the soft tissues are involved (such as with tendon ruptures).

TREATMENT

Treatment for most finger injuries is nonsurgical, conservative approach that may involve RICE (rest, ice, compression, elevation), splinting, anti inflammatory medications for swelling/pain, and rehabilitation exercises.  Reduction may be performed on some simple fractures and supported with splinting or “buddy taping” (practice of taping the injured finger to a nearby uninjured finger to limit mobility and provide splint-like support).

More serious injuries and those unresponsive to conservative treatment may require surgical repair and an aggressive post-surgical hand and upper extremity therapy program.

PREVENTING INJURY

Injury prevention is always preferable for athletes wanting to give it their all during the sports season.  There are some things you can do to reduce risk of injury during sports this fall and the seasons to come:

  • Avoid wearing rings or other jewelry when playing.
  • Opt for closed fist rather than open hand approaches in volleyball and blocking in football.
  • Buddy taping (as mentioned above) can also be effective in preventing finger injury in a number of different sports.
  • Finger bracing should be worn in both practice and games until symptoms of a mildly injured/painful finger resolves, to avoid more serious injury/damage.
  • Finger and hand strengthening exercises can be beneficial.

Playing with an Injury

When is it Okay to Return to Play?

As fall sports heat up, we begin to see a lot of injuries.  The first question players ask after we confirm their injury is, “how soon before I can play again?

Whether it’s a junior high schooler, college athlete or professional player, this question is asked with the same passion and underlying conviction to do whatever it takes to get back in as soon as possible.  This is their sport and their heart is all in – despite the injured limb and challenge it now presents.

Kinkaid Team Captain and outside linebacker, Harris Green, not slowed by forearm fracture

As an orthopedic physician who wants to ensure the best outcome in their recovery and a team doctor who understands this drive distinct in athletes, it’s important to develop the right treatment plan – some of which might entail permission for immediate return to play.

Green back in the game as fracture heals

While this may seem counterintuitive, certain hand and upper extremity fractures once stabilized and placed in a cast are fine for an immediate resumption of play.  This is particularly true of the younger athlete.  Some of the types of fractures allowing athletes to return quickly back to the game despite their cast or splint include certain finger and distal radius fractures and ligament sprains.

While the position on a team will impact the enthusiasm in our recommendation to allow such return to play – linemen with the capability to restrict their hands in a cast verses a receiver or running back more fully engaging their injured limb – many are as capable to play their position with their injury as they were before.

The type of injury is also a determination – stabilized fractures are more likely to be considered for immediate return to play than ligament or tendon tears.

Now, there are some risks for further damage if the injured limb is hit in such a way and the inflexibility of the cast places other vulnerabilities on the uncasted portion of the limb.  Other risks include refracture, retear of a tendon or displacement of a fracture.

But, the only way to truly avoid further injury is to sit out of the game until the injury is completely healed. And this is rarely an option for an athlete.

So, we ensure that our patients know everything upfront.  And we give them the tools to keep their injured limb as strong as possible – regardless of the decision they make.   Continuing to keep the injured limb strong by exercising the muscles and joints around the injury, in conjunction with cardiovascular exercise for overall physical well-being….is key.  We remain very involved and ready to make any readjustments we need to the treatment.

The Different Types of Fractures

A fracture is a break in the bone. Within the hand and upper extremity it can occur anywhere from the fingertip to the shoulder.

Among the most common fractures and dislocations of the hand and upper extremity include:

  • Finger Fractures
  • Distal Radius Fractures (also called Colles Fracture)
  • Scaphoid Fractures
  • Forearm Fractures
  • Clavicle Fractures (collar bone)

There are a number of different types of fractures – partial or complete, simple or compound, clean or shattered …each with their own classifications.  It is important to first define the type of fracture and its severity before determining the most effective treatment plan.

Fractures are defined by the severity of the break and the impact it imposes to surrounding tissue. Some fractures known as partial fractures may only cause a slight crack in the bone, while others may result in a complete break or shattered bone.

A fracture may also be either open or compound, which is a fracture that pierces through the skin creating an open wound.  A closed or “simple” fracture is a fracture that does not break through the skin.

Other classifications that help determine the best treatment plan for your type of fracture include:

  • Transverse Fracture – A fracture that goes across the bone and is situated at a right angle to the long axis of the bone.
  • Greenstick Fracture – A fracture situated on only one side of the bone, causing a bend but not a complete break. These are most commonly seen in children with more “pliable” bones.
  • Comminuted Fracture – A fracture that results in three or more bone fragments.
  • Intra-articular Fracture – A fracture with joint involvement.

Depending on the severity of the fracture, treatment may entail the non surgical realignment of the bone and casting, also referred to as closed reduction. Or surgical repair utilizing fixation support may be indicated.